Individual
JASON H SMOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4747 ARAPAHOE AVE, BOULDER, CO 80303-1131
(303) 415-7000
Mailing address
42 GARDEN CTR, BROOMFIELD, CO 80020-1730
(303) 465-0401
(303) 438-1351
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
45525
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03237044
—
CO
01
—
P00432605
MEDICARE RAILROAD
CO
Enumeration date
07/10/2006
Last updated
03/15/2021
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